The introduction of interventional devices into a given arterial or venous vessel for a variety of purposes, such as for performing percutaneous transluminal coronary angioplasty (PTCA) or for delivering and implanting a stent or stent graft, is well known in the art. Several techniques for introducing such catheters are available, including the Seldinger technique. Broadly described the Seldinger technique involves surgically opening a vein or artery with a needle, inserting a guidewire into the vein or artery through the lumen of the needle, withdrawing the needle, inserting over the guidewire a dilator located inside an associated sheath introducer having a hemostasis valve, removing the dilator and inserting a catheter through the hemostasis valve and sheath into the blood vessel. During this process, care must be exercised to prevent introduction of air into the vessel and to avoid leakage of blood from a proximal end of the sheath introducer. To avoid the risk of both air embolism and blood contamination of the clinician conventional introducers employ various types of hemostasis valves having a single proximal input port that is designed for use with catheters and guidewires that have various diameters.
In interventional procedures where it may be necessary to simultaneously utilize multiple interventional devices, such as procedures for percutaneously delivering and implanting endovascular grafts for treatment of certain types of abdominal aortic aneurysms, a sheath introducer with a hemostasis valve having a single proximal input port may not ensure hemostasis of each interventional device in use during the procedure. In such cases, a clinician may utilize a puncturable hemostasis valve that can be adapted to achieve modest hemostasis of multiple devices introduced through multiple punctures or alternatively modify a hemostasis valve known in the art by puncturing additional openings to introduce additional device(s), although hemostasis is generally very poor with this practice. As such a need exists in the art for a sheath introducer that ensures hemostasis during treatments that require the simultaneous introduction and manipulation of multiple catheters or other interventional devices.